Meet Dr. Jennifer Santamaria, PT DPT of Femme Strong
When was the last time you considered your pelvic floor strength?
That’s probably not a question you’ve considered everyday — but maybe it should be!
Pelvic floor strengthening aids in bladder control, assists in childbirth recovery and improves sexual dysfunction.
What is Femme Strong?
Femme Strong is a mobile therapeutic practice headed by Dr. Jennifer Santamaria – Doctor of Physical Therapy. Dr. Jenny brings her extensive knowledge and services to her clients’ homes to accommodate a feeling of overall relaxation and convenience.
Dr. Jenny asks the right preliminary questions
Dr. Jenny encourages her new patients to visit her website and access her questionnaire that helps clarify the appropriateness of addressing one’s pelvic floor condition. Here are a couple of questions Dr. Jenny would like you to consider:
- Do you have urine leakage, incontinence or vaginal flatulence after sneezing, coughing or laughing?
- Does jumping, stretching or other types of physical activity cause urine leakage?
- Are you visiting the restroom more than seven times a day?
These are just a few of the important questions to consider when you think of your pelvic health. Visit the Femme Strong website to access and the full list.’
Ask the doc about pelvic floor strength & PT
I decided the best way to explore the importance of Dr. Jenny’s Femme Strong therapeutic practice was to ask this innovative physical therapy doctor a series of 20 questions. With wide-ranging thorough responses, prepare to be informed!
- What do you prefer your patients call you – Dr. Santamaria, Dr. Jenny or Dr. S?
Dr. Jenny works best!
2. How long have you had your physical therapy practice?
Femme Strong has been in business for 1.5 years, but I’ve been practicing for 4 years.
- Who is your typical client? What are her issues?
- A woman of any age who may leak a little in her underwear with certain activities or when feeling an urge to pee.
- A woman who has been dealing with pelvic pain whether from illness, childbirth or trauma but has been told there is nothing to be done by her medical provider.
- A pregnant or postpartum woman who has developed abdominal, vulvar or lower back pain discomfort or pain from the changes in her body.
- What are Kegels and are they effective? Why or why not?
A proper Kegel is when you contract your pelvic floor muscles which are the muscles that surround your vulva and rectum in tune with proper breathwork. If done correctly, there should be no glute squeeze, thigh squeeze or “sucking in” of the abdomen. For most women they are actually not effective in treating any type of pelvic floor symptoms ranging from incontinence/leakage to pain with intercourse.
Most of the time, women have built up excessive tone in their pelvic floor so much that it’s actually causing their symptoms, so the correct route to take is learn how to relax the pelvic floor muscles first. Then, you can go into learning how to properly control your pelvic floor so you develop the needed coordination between contracting and relaxing.
This is important because both are needed with different daily functions. Your pelvic floor needs to relax to give birth, pee and enjoy sex. Then it needs to contract to support you during exercise and standing upright.
- How are the needs of younger women different from those of older women? Can you breakdown female pelvic conditions according to a woman’s life stages: childbearing years, peri-menopausal years and menopause?
Conditions can blend into different stages of life, but it’s common to see younger women dealing with pelvic floor dysfunction from endometriosis, polycystic ovarian syndrome and interstitial cystitis. Childbearing women may have pelvic floor dysfunction from overactivity of the pelvic floor during exercise, cesarean and episiotomy scars, pelvic organ prolapse and diastases recti [stretching of the six-pack ab muscles during pregnancy, causing belly bulging months, or years, beyond childbirth]. Older woman might have pelvic pain from tissue thinning and loss of lubrication during menopause, pelvic organ prolapse or weakened pelvic floor muscles.
- What’s the most frequent condition/dysfunction you treat?
Regardless of the cause (pregnancy, illness, trauma or aging), most commonly I see women who have overactive pelvic floor muscles that then cause a variety of symptoms ranging from pelvic pain, incontinence and leakage. Overactive pelvic floor muscles occur from all types of conditions including PCOS, endometriosis, sexual trauma, birthing and menopause!
- What can pregnant women expect to achieve working with you during their pregnancies? How long do you work with women throughout the course of their pregnancies?
Women in their first and second trimester will learn pregnancy safe mobility and strength exercise methods that help maintain pelvic and core strength as they grow their baby to prevent lower back pain and diastases recti. In the third trimester, we then focus on pelvic floor relaxation with perineal massage and any other techniques that would be beneficial to reduce pelvic floor tension and allow for labor to be smoother and easier.
We also go into education on the variety of positions they can safely deliver their baby in and positions to prevent tearing. (It doesn’t have to be in the lithotomy position [supine with legs bent at 90 degrees at the hip] — even if you had an epidural!) Along the way, we also address any new pains or discomforts that the body may be feeling as it adjusts to the growing baby!
- Do repeat pregnancies (second, third, fourth, etc.) present unique challenges for women and their pelvic health?
They definitely can! If there was no rehab after your first baby, chances are that your pelvic floor and core did not recover as they should. Our bodies can do remarkable things, but returning to pre-pregnancy pelvic floor and core strength is one area that doesn’t occur on its own. Therefore, any future pregnancies will feel a bit more uncomfortable, and you may be susceptible to further secondary effects such as diastasis recti and pelvic organ prolapse [POP — occurs when pelvic organs slip down and create a bulge in the vagina]
Furthermore, if you had leakage or prolapse after your first baby, it will continue after any future pregnancies and possibly get worse. Pelvic pain that is also not addressed after the first delivery will result in a higher risk for future tearing, which you definitely don’t want especially since it will result in increased scar tissue that then cause more pain and discomfort with insertion!
- What’s the best advice for maintaining pelvic health from one pregnancy to the next?
After pregnancy the most important aspect is to maintain good mobility of your pelvic floor. Doing breath work and yoga to understand how to relax and contract the pelvic floor when necessary is ideal to maintain good pelvic health between pregnancies.
- How do you help postpartum women? What’s the duration of a postpartum course of therapy?
Postpartum physical therapy can greatly vary from woman to woman. Initially, it’s important to always learn how to breathe properly to help your pelvic floor recover. Then we go into core control and learning how to properly stabilize your body via proper core activation. If there was a perineal or cesarean scar, we work on helping it heal properly so there is less scar tissue that limits mobility in the future. If a mama has prolapse or incontinence, we then go into learning how to properly activate the pelvic floor and core and apply it to breath work to overcome those symptoms. Then if a mama is looking to return to a high-level activity/exercise, such as running, we progress the core/pelvic floor control and learn how to activate them properly to have stability during these activities and prevent any leakage or pain.
Ideally, we continue working together until your goals are met; that may be 6 weeks or 4 months it really depends on your healing journey and your ultimate goal.
- How do you help educate women about strengthening their pelvic floors?
This one is a hard one! There’s this idea that Kegels fix pelvic floor issues, when in reality, only doing Kegels results in more damage than good. So, I will usually always educate women on relaxing the pelvic floor because ultimately that helps it heal more so than strengthening. But when it does occur that strengthening is necessary, we use tactile cues and imagery to learn how to properly activate the pelvic floor (and relax it) while building power and endurance to have it be able to support your body during all activities and all positions.
- I know you specialize in working with women, but how (and do) men benefit from a stronger pelvic floor?
Yes! The strength aspect applies to men, too. It’s usually that their pelvic floors are hyperactive and don’t need strengthening work but instead, relaxation. For men, pelvic floor dysfunction can result in erectile dysfunction, pain with ejaculation/urinating and bowel/bladder dysfunction.
These are sensitive topics for a lot of men, and a lot of times they’re less likely to receive pelvic floor rehab for these conditions than a woman is for hers! There’s not many pelvic floor PT’s that treat men, but they are out there!
- How do you help women improve sexual dysfunction related to the strength of their pelvic floor?
Most of the time, when women have sexual dysfunction, it is once again due to an overactive pelvic floor. So, whether it’s pain with penetration (dyspareunia) or orgasm dysfunction we first focus on becoming aware of the pelvic floor’s resting state and learning how to let it relax. We may apply some manual therapy treatments to help reduce the tone/overactivity and in turn help the nerve endings have better signal pathways to the brain to create clear pleasure signals versus pain ones. There’s usually always homework involved with our treatment sessions and many times we incorporate dilators or pelvic wands to reduce tone and progressively allow for pelvic floor relaxation.
- What other types of orthopedic dysfunctions do you help women overcome?
Really anything that you can think of! Any spinal conditions, hip conditions, ankle conditions, shoulder pain, etc. During school, I focused on orthopedic physical therapy and so I have a vast in-depth knowledge and clinical expertise on how to treat all types of orthopedic conditions, and what’s pretty great is that working on the pelvic floor can actually improve some of the pains and diagnoses that you have in other joints!
- How quickly do women see results after a course of therapy with you?
Each body is different and each woman’s experience varies but with consistency and dedication most women start seeing a notable difference and improvement within 4-6 sessions.
- Once pelvic strength is achieved can it be lost?
Not necessarily. One of my objectives when I work with you is that you fully understand the importance of the pelvic floor when it comes to everyday function. Once you learn how to properly engage it and remember when to let it relax you can apply it to every single activity you do in your life and as long as you keep that up, your pelvic floor will function as it should, forever and ever. And it’s a lot easier than you think, it eventually becomes a habit and then your body does it for you!
- Does regular aerobic and/or strength training (weight-bearing), hip and leg exercises, help maintain a woman’s pelvic strength/health?
Movement, in general, helps your pelvic floor health, but if you have some type of dysfunction some forms of exercise can make it worse (i.e., running and weightlifting). So, if you do have some type of pelvic floor dysfunction, I recommend you go through pelvic floor PT first before trying any of those high-level exercise activities, but if you’re pretty good [in that department] then go for it and get your fitness on!
- What’s one tip (or bit of advice) that women can employ immediately to better their pelvic floor strength as they prepare for their first appointment with you?
Start practicing your diaphragmatic breathing: inhale through your nose and let all the air go into your belly so it rises instead of your chest. Then, exhale through your mouth and feel your belly return to a neutral position. Practicing this in varying positions including lying on your back, sitting and standing will help give your pelvic floor the relaxation it needs and begin to set you up for success.
- How long is a typical therapy visit?
Initial sessions are 90 minutes long and follow up are usually 60 minutes.
- What’s the best way for our audience to schedule a visit with you?
Give me a call! I love to chat with the women I work with first and get a better understanding of their situation. That way I can explain the benefits of working together and answer all questions and concerns prior to our session. I do offer complimentary discovery visits which gives us 30 minutes of uninterrupted time to get to know your situation and discuss a preliminary plan of care — something most doctors don’t offer! So, if you want to take advantage of that, you can easily schedule that through my website.
Dr. Jenny is a straightforward, kind and approachable practitioner. Her knowledge of pelvic floor strength and the ways it relates to childbirth, and overall female wellbeing, is helpful to women looking for answers to improve their unique circumstances.
The North County Moms is honored to add Femme Strong to its list of community-leading, marketing partners!